Complex pelvic fracture with massive hemorrhage in low resource settings: Case report

Pelvic fractures can range from simple, requiring almost no therapy, to complex, mandating the attention of the orthopedic surgeon, trauma surgeon, interventional radiologist, or other specialists because they are associated with multisystem injury and life-threatening hypotension. We present a 16-year-old male who presented with a complex pelvic fracture following a motor vehicle accidents that did not survive despite the efforts in resuscitation. In complex pelvic fracture with hemodynamic instability (hypotension persevered) and high index suspicion of bladder injury, there is an immediate need for operative intervention, regardless of negative/positive FAST (Focused Assessment with Sonography in Trauma).

Urethral calculus with a recurrent acute urinary retention in a male child aged 11 years: A case report

Urolithiasis is the presence of a stone anywhere in the urinary tract, it is commonly seen in adult patients and rare in children, especially when it is associated with acute urinary retention. In children, history is not suggestive and not specific; diagnosis is made by exclusion, and imaging studies often get the findings as incidental. In this case, the clinical presentation made early diagnosis quite difficult. The management of urethral calculi varies according to the site, size, associated urethral pathology, and available resources. It becomes an emergency when it causes acute urinary obstruction, urethral bleeding, or pain. We present a case report of an 11-year-old male with a history of 3 episodes of acute urinary retention secondary to urethral obstruction by calculi. The period between 1 episode and the next was observed to be approximately 1 year, with no logical explanation. Urethral calculus in children is less frequent than in adults worldwide. Urethral calculi are either formed in the native urethra or migrate from the upper urinary tract. Urgent urinary diversion and removal of the calculus with minimal urethral trauma is the recommended treatment.